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Flat lesions in CT colonography.
Antonella Lostumbo1, Kenji Suzuki, Abraham H Dachman
1Department of Radiology, MC 2026, University of Chicago Hospitals, 5841 S. Maryland Ave., Chicago, IL 60637, USA.
Abdominal Imaging
|July 28, 2009
Summary
CT colonography (CTC) can effectively detect flat neoplastic lesions, such as adenomas and adenocarcinomas. Proper techniques, including fecal tagging and 3D/2D analysis, improve detection rates for these potentially advanced colorectal cancers.
Area of Science:
- Gastroenterology
- Radiology
- Oncology
Background:
- Flat lesions in the colon are controversial due to concerns about CT colonography (CTC) insensitivity, despite their potential for advanced neoplasia.
- Lack of a uniform definition for "flat" lesions contributes to variable reported incidences in prior studies.
Purpose of the Study:
- To evaluate the detectability of flat neoplastic lesions using CT colonography (CTC).
- To emphasize recent findings suggesting CTC's efficacy in detecting flat neoplasia when specific criteria are applied.
Main Methods:
- Review of recent CT colonography (CTC) literature focusing on flat lesions defined as neoplasia (adenomas or adenocarcinoma).
- Application of fecal tagging and meticulous search strategies using both 3D and 2D imaging techniques.
- Consideration of computer-aided detection (CAD) as a supplementary tool.
Main Results:
- Recent literature indicates a low incidence of flat lesions when defined as neoplasia.
- Most flat neoplastic lesions are detectable by CT colonography (CTC).
- Fecal tagging and careful 3D/2D examination enhance the detection of flat lesions.
Conclusions:
- CT colonography (CTC) is capable of detecting flat neoplastic lesions.
- Standardized definitions and optimized search methods are crucial for maximizing CTC's sensitivity for flat lesions.
- Computer-aided detection may further improve the identification of these lesions.
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